Study Of The Relationship Between Helicobacter Pylori Infection And Non-Alcoholic Fatty Liver Disease And Its Combined Gallbladder Disease

Objective:Non-alcoholic fatty liver disease(NAFLD)is one of the most prevalent causes of chronic liver disease worldwide,with no specific therapeutic drugs available and an increasing clinical burden.Recently,the relationship between Helicobacter pylori(H.pylori)infection and the development of NAFLD has been widely reported,with many studies pointing to a positive correlation between H.pylori infection and NAFLD.To investigate whether H.pylori infection promotes the progression of NAFLD and indicators related to metabolic syndrome(MS),and to assess the risk of gallbladder disease in NAFLD patients with combined H.pylori infection,may provide new means of prevention and treatment for NAFLD and NAFLD patients with combined gallbladder disease.Methods:In this study,complete clinical data of 128 patients eligible for NAFLD diagnosis from October 1,2016 to December 31,2021 at the First Hospital of Lanzhou University were collected.The patients were divided into the group with H.pylori infection and the group without H.pylori infection according to whether they were co-infected or not,and the age,gender,BMI,LSM,CAP,liver fibrosis,serological parameters,diabetes mellitus,and hypertension were compared between the two groups.The relationship between H.pylori and the risk of gallbladder disease in patients with NAFLD was analyzed using binary logistic regression.Results:Among the 128 patients with NAFLD included in this study,there were59 patients with comorbid H.pylori infection and 69 patients without comorbid H.pylori infection.(1)The clinical data of patients with NAFLD combined with H.pylori infection compared with patients with NAFLD without H.pylori infection:the population aged 50-59 years was the main population in the H.pylori positive group,and the population aged 50-59 years was the main population in the H.pylori negative group,and the differences between the two groups in terms of gender and age were not statistically significant(P>0.05);the degree of severe hepatic fat attenuation(X~2=12.584,P=0.002)and liver stiffness(X~2=5.090,P=0.044)were higher in NAFLD patients with combined H.pylori infection than in the H.pylori-negative group,with statistically significant differences between the two groups;compared to H.pylori-negative NAFLD patients,APRI,Fi B-4,ALT,AST,GGT,Ty G,LDH,TC,TG,LDL-C,HDL-C,TBIL,DBIL,WBC,NLR were higher in H.pylori-positive patients(P<0.05),and the proportion of patients with combined hypertensive disease and diabetes mellitus was higher(P<0.05),and the differences in ALB,BMI,GLU,and HCY were not statistically significant(P>0.05);(2)A total of 114 patients(54 in the H.pylori-positive group and 60 in the H.pylori-negative group)with NAFLD in this study did not have their gallbladders removed,and H.pylori infection made patients with NAFLD more prone to gallbladder disease(OR=1.10395%CI:1.019～1.569 P=0.009);H.pylori infection was the cause of chronic cholecystitis(OR=1.391 95%CI:1.165～1.929 P=0.033),gallbladder stones(OR=1.578 95%CI:1.248～1.851 P=0.020)and gallbladder polyps(OR=1.19095%CI:1.067～1.535 P=0.002)as independent risk factors.Conclusion:H.pylori infection may aggravate hepatic steatosis,liver stiffness,liver fibrosis,liver dysfunction,lipids,degree of inflammation,diabetes,and hypertension in patients with NAFLD,and H.pylori infection may put patients with NAFLD at increased risk for comorbid gallbladder disease.